At least 65,000 cancer patients will develop symptomatic spinal metastatic lesions this year. Additionally, approximately 30-70% of all cancer patients exhibit spinal metastasis at autopsy indicating that the prevalence of problematic spinal tumors will increase as life expectancies and survival rates increase. Spinal tumors are often excruciatingly painful and debilitating to the patient. Treatment strategies for metastatic spinal lesions are palliative in nature and are targeted toward reduction of tumor mass, alleviation of pain, preservation of neurological function, and stabilization of the spinal column. Percutaneous vertebroplasty, whereby liquid cement is injected into the body of the affected vertebra has become a popular method for managing spinal metastases. Currently, vertebroplasty is performed in conjunction with tumor reduction most often through radiation or chemotherapy. This dual treatment approach increases the cost of management and may leave patients with continuing pain until both treatment regimens have bean completed. In Phase I, we proposed coupling targeted thermal ablation of tumors with parcutaneous vertebroplasty as a single treatment technique, which is effective at accomplishing all the goals of current therapies at once. We demonstrated the feasibility of this technique in an animal model and showed that magnetic resonance image guided laser therapy allows visualization of laser heating and safe control of lesion size. This system may be ideal for guidance of safe laser ablation of spinal tumors in conjunction with vertebroplasty. In this proposal, we will further develop this technique in animals with the goal being to port the system to a new interventional image-guided surgery facility for evaluation. In conjunction with interventional radiologists at the M.D. Anderson Cancer Center in Houston, Texas, we will then evaluate the procedure in a small human clinical study. [unreadable] [unreadable]